From Current Evidences to Clinical Practices

in Sepsis อ.นพ.พรอนันต์ โดมทอง

พ.บ. (เกียรตินิยมอนัดบั 2), วว. อายรุศาสตร์, วว. เวชบ าบดัวิกฤตวว. อายรุศาสตร์โรคระบบการหายใจและภาวะวิกฤตการหายใจ

กลุม่งานอายรุกรรม โรงพยาบาลศนูย์ขอนแก่น

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjuyPPdwJXMAhUBMZQKHZUODLIQjRwIBw&url=http://www.biomerieux.it/servlet/srt/bio/italy/dynPage?doc=ITL_NWS_EVN_G_EVT_1&psig=AFQjCNF5xsQjwm3wk0pkEYJwsugR1zFk8Q&ust=1460976688732937

http://slideplayer.com/slide/678073/

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwittcytxpXMAhWHW5QKHcCyB9gQjRwIBw&url=http://www.nejm.org/doi/full/10.1056/NEJMra043632&psig=AFQjCNGkULLsLkf3ORLsuJjR7EGUWxCQ9w&ust=1460978060415234

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiO2ZKbypXMAhWGkJQKHQXZCn0QjRwIBw&url=http://www.consultant360.com/articles/surviving-sepsis-campaign-2014-update-management-and-performance-improvement-adults-severe&psig=AFQjCNFrHqOfgFSyK7MWvPYDw7jQ_TxXMg&ust=1460978348671283

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwj66p3tyJXMAhUH5KYKHSIKCuYQjRwIBw&url=http://rebelem.com/the-protocolised-management-in-sepsis-promise-trial/&psig=AFQjCNFrHqOfgFSyK7MWvPYDw7jQ_TxXMg&ust=1460978348671283

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiHpIfewpXMAhUBvZQKHUniBa4QjRwIBw&url=http://www.srlf.org/nouvelles-definitions-sepsis-choc-septique/&psig=AFQjCNF5xsQjwm3wk0pkEYJwsugR1zFk8Q&ust=1460976688732937

KEY CONCEPTS OF SEPSIS

KEY CONCEPTS OF SEPSIS (2)

NEW TERMS AND DEFINITIONS

NEW TERMS AND DEFINITIONS (2)

NEW TERMS AND DEFINITIONS (3)

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjDz6K7wZXMAhVHUZQKHZKYCTYQjRwIBw&url=http://www.heftemcast.co.uk/papers-of-march/&psig=AFQjCNF5xsQjwm3wk0pkEYJwsugR1zFk8Q&ust=1460976688732937

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjjnJ2ewZXMAhXCipQKHSnfBYoQjRwIBw&url=http://rebelem.com/sepsis-3-0/&psig=AFQjCNF5xsQjwm3wk0pkEYJwsugR1zFk8Q&ust=1460976688732937

https://www.youtube.com/watch?v=1S8l5D2xr6w

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjqtaPewZXMAhXBJ5QKHYnKBEYQjRwIBw&url=http://rebelem.com/sepsis-3-0/&psig=AFQjCNF5xsQjwm3wk0pkEYJwsugR1zFk8Q&ust=1460976688732937

Implications of the new definitions for screening and management

Step 1: Screening and management of infection

Step 2: Screening for organ dysfunction and management of sepsis

Step 3: Identification and management of initial hypotension

https://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiRhr7RxpXMAhWGFZQKHbO5DNgQjRwIBw&url=https://twitter.com/suzettewoodward/status/374081748621328384&psig=AFQjCNFrHqOfgFSyK7MWvPYDw7jQ_TxXMg&ust=1460978348671283

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwitreT7xpXMAhXClJQKHbbyDhQQjRwIBw&url=http://www.upmc.com/media/NewsReleases/2015/Pages/seymour-septic-shock.aspx&psig=AFQjCNFrHqOfgFSyK7MWvPYDw7jQ_TxXMg&ust=1460978348671283

Phase out

140-180 mg/dl

Fluid therapy is the drug :It can cure, it can danger.

FLUID is the mainstay treatment in early phase of treatment in septic patients : Right time, Right dose, Right type.

http://www.uspharmacist.com/content/d/feature/c/35937/

Resuscitation

Maintainenceand

homeostasis

Removal And

recovery

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwitreT7xpXMAhXClJQKHbbyDhQQjRwIBw&url=http://www.biomerieux-diagnostics.com/vidas-brahms-pct&psig=AFQjCNFrHqOfgFSyK7MWvPYDw7jQ_TxXMg&ust=1460978348671283

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwivvN2ZwpXMAhWJNJQKHX8HC8EQjRwIBw&url=http://global-sepsis-alliance.org/world-sepsis-day/&psig=AFQjCNF5xsQjwm3wk0pkEYJwsugR1zFk8Q&ust=1460976688732937

Conclusion

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjv-PDmwZXMAhUEk5QKHZbhAxcQjRwIBw&url=http://blog.clinicalmonster.com/2016/03/mo/&psig=AFQjCNF5xsQjwm3wk0pkEYJwsugR1zFk8Q&ust=1460976688732937

http://www.google.co.th/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjw1ojbx5XMAhUMNpQKHVPuB6sQjRwIBw&url=http://rebelem.com/rebelcast-sepsis-care-in-2015/&psig=AFQjCNFrHqOfgFSyK7MWvPYDw7jQ_TxXMg&ust=1460978348671283